Cervical spine injury can pose great challenge to the medical team due to involvement of neurologic, cardiovascular and respiratory systems. Airway management in an unstable cervical spine injury can be the most challenging part for an anaesthesiologist as it can have serious implications if not well managed. In our patient with unstable cervical spine, airway management had to be altered from the ideal method of using fiberoptic bronchoscope. Overall idea is to prevent deterioration of previous injury without inciting any new injury besides maintaining other vital parameters. With anterior fixation of cervical spine, extubation was equally critical. Here we present the anaesthetic management of an unstable cervical spine injury posted for emergency anterior discectomy and fixation.